本文選題：組織工程　切入點：螺旋CT　出處：《安徽醫(yī)科大學》2012年碩士論文　論文類型：學位論文

【摘要】：研究目的 在口腔頜面外科的科學研究及臨床工作方面，頜面部腫瘤、外傷或先天疾病等是造成頜面部組織缺損的常見原因。頜骨及軟組織的缺損不僅導致口腔頜面部的生理功能障礙，也會對患者的心理造成嚴重的不良影響，因此組織缺損尤其是頜骨缺損的修復重建已成為口腔頜面外科領域和范疇迫切需要解決的難題之一。近年來發(fā)展的各種無機和有機，且具有生物相容性的骨代用品拓寬了骨缺損修復與重建的研究領域，使骨組織工程支架材料為這一難題的解決提供了可行的辦法。經(jīng)過前期的一系列動物實驗證實無機誘導因子復合性骨組織工程支架材料具有良好的生物相容性，，植入骨缺損區(qū)后可在降解過程中釋放具有骨生長誘導作用并由特定比例構成的無機元素，從而起到促進骨組織增殖、分化和新骨形成的功能。為臨床的應用研究提供了可靠的理論依據(jù)，可以作為修復人體頜骨缺損的材料之一。 本實驗研究應用64排128層螺旋CT來觀察應用無機誘導因子復合性骨組織工程支架材料修復頜骨缺損術后患者頜骨骨質(zhì)缺損修復與重建的情況。意圖通過相關實驗數(shù)據(jù)來評估骨組織工程支架材料在修復重建骨缺損和促進成骨方面的功能。旨在為材料治療提供更加準確、直觀的影像學依據(jù)。 研究方法 選擇2008年1月—2010年12月，安徽省立醫(yī)院口腔頜面外科收治入院的頜骨囊腫或囊性腫瘤患者138例。術前均有我院全景片及CT等影像提示。手術均由同一組外科醫(yī)生采用外科切開刮除的方法。充分暴露病變骨質(zhì)后去除囊腫表面骨質(zhì)，徹底刮除囊壁，實驗組在缺損處置入本材料，待骨腔內(nèi)鮮血浸潤材料后，分層對位縫合創(chuàng)面。對照組患者骨殘腔內(nèi)不放置任何材料即對位縫合。通過兩組患者于術后1,3,12個月來我院復診，行CT檢查，分析其CT值得出數(shù)據(jù)，并將結果進行對比研究。 結果 由CT值結果顯示對照組患者因未行任何修復措施，囊腫破壞的骨質(zhì)得不到較好的修復，只能靠患者自身骨修復，速度較緩慢，因此骨密度與術前無異。而實驗組患者由于在骨腔內(nèi)置入預制型無機活性誘導元素支架材料，所有患者患區(qū)的骨質(zhì)都得到了很好的修復，且有68.12%的患者骨質(zhì)恢復情況與正常骨質(zhì)無異。 結論 無機活性誘導元素骨組織工程支架材料在用于骨缺損修復時能有效促進成骨細胞生長、分化，提高其成骨特性。螺旋CT三維重建技術對材料的成骨特性提供了準確、直觀的影像學依據(jù)。
[Abstract]:Research purpose. In the scientific research and clinical work of oral and maxillofacial surgery, maxillofacial tumors, trauma or congenital diseases are the common causes of maxillofacial tissue defects. Therefore, the reconstruction of tissue defects, especially jaw defects, has become one of the most urgent problems in the field and field of oral and maxillofacial surgery. And the biocompatible bone substitute broadens the research field of bone defect repair and reconstruction. The bone tissue engineering scaffold materials provide a feasible method for solving this problem. A series of animal experiments have proved that inorganic inducible factor composite bone tissue engineering scaffold materials have good biocompatibility. After implantation of bone defect area, inorganic elements with bone growth induction and a specific proportion of inorganic elements can be released during the degradation process, thus promoting the proliferation of bone tissue. The function of differentiation and new bone formation provides a reliable theoretical basis for clinical application and can be used as one of the materials for repairing human jaw defects. In this study, 64-slice 128-slice spiral CT was used to observe the repair and reconstruction of mandibular bone defects after the repair of jaw defects with inorganic inducible factor composite bone tissue engineering scaffolds. To evaluate the function of bone tissue engineering scaffolds in repairing bone defects and promoting osteogenesis. Visual imaging evidence. Research method. Choose January 2008-December 2010, 138 cases of maxillary cyst or cystic tumor were admitted to the Department of Oral and Maxillofacial surgery in Anhui Provincial Hospital. The panoramic films and CT images of our hospital were all shown before operation. The surgical procedures were all performed by surgical incision and curettage by the same group of surgeons. ... to remove the bony surface of the cyst after full exposure of the diseased bone, After completely scraping the cyst wall, the experimental group will dispose of the material in the defect, and after the material has been infiltrated with blood in the bone cavity, The patients in the control group were sutured at the same position without any material placed in the bone remnant cavity. The patients in the two groups were re-diagnosed in our hospital for 12 months after the operation. The CT scan was performed, and the CT data were analyzed and the results were compared and studied. Results. The results of CT showed that the bone damaged by cysts could not be repaired better in the control group because of no repair measures, but only by the patients' own bone repair, and the speed was slow. So BMD was the same as before surgery, and the patients in the experimental group were well repaired because of the placement of prefabricated inorganic active inducer scaffolds in the bone cavity. And 68.12% of the patients had the same status of bone recovery as normal bone. Conclusion. Bone tissue engineering scaffolds with inorganic active inducing elements can effectively promote the growth and differentiation of osteoblasts and improve their osteogenic characteristics when they are used for bone defect repair. The three-dimensional reconstruction of spiral CT provides an accurate method for the osteogenic characteristics of the materials. Visual imaging evidence.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R318.08

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